coping with mental illness at America’s happiest college

Brown may be ranked among the nation’s happiest colleges, but the truth is that life here isn’t always fun, games, and a cappella. Just like any other university, Brown has its fair share of troubled students—undergrads beset with either mental or physical illness (or sometimes both), who struggle to deal with their problems while fulfilling their academic responsibilities.

Sometimes these students find themselves in such dire situations—they may be failing classes, or, at worst, may have attempted suicide—that the Office of Student Life advises or requires that they take a one-year leave of absence.

While it goes without saying that extreme cases warrant forced medical leave, it’s unsettling to think that Brown’s administration has the power to send students home against their will.

But Associate Dean Maria Suarez says mandated leaves are “very, very rare” at Brown, and are reserved only for students opposed to leaving campus and who pose an “imminent risk” to themselves or to others.

Belinda Johnson, the director of Psychological Services, affirms that most students who go on medical leave do so voluntarily—though she does add that most students are initially opposed to the idea.

“It sometimes takes students a long time to figure out that that’s what they want to do,” she says. “It’s not often the case that students wake up in the morning and say, ‘I want to take a medical leave.’”

One student, who asked to remain anonymous, had what seems to be the typical experience with medical leave last semester. It was her decision to go on medical leave, though she received strong encouragement from University administrators.

Let’s call her Lauren. Last fall, during her very first days as a freshman on College Hill, she found herself overwhelmed by depression and severe anxiety—problems that she’d been dealing with long before her arrival at Brown.

“At the beginning of the year, I was having basically nightly anxiety attacks, so I’d end up just running around campus at two in the morning, not having any idea what was going on,” she recalls. “It got to a point where I couldn’t do my work—I was pretty non-functional.”

By the second week of school, Lauren had already met with a dean in the Office of Student Life, after being referred there by a concerned professor. The dean, as well as therapists in Psychological Services, urged Lauren to leave campus, but she initially refused.

“They did attempt to send me home, about a month in,” she says. “I had to literally convince the deans to let me stay.”

In order to stay on top of her workload, Lauren requested extensions from professors, but her depression and constant anxiety attacks made it impossible for her to do well in her classes. Throughout the semester, even as late as November, deans and therapists in Psychological Services encouraged her to return home. “What they said is they don’t see a reason for prolonging any suffering,” she says.

Near the end of the fall semester, finding that her depression made it almost impossible to focus on her responsibilities as a student, Lauren finally chose to take some time away from Brown.

“You can’t really stay in school and fail all your classes,” she says. “It just doesn’t make sense.”

While most students who go on medical leave recognize that they need to get away from school to sort out their issues, many are turned off by the prospect of leaving Brown—not for just one, but for two full semesters.

Technically, there is no official two-semester rule in place. But since students on medical leave must apply for readmission either in November or May, it is difficult for them to take a medical leave shorter than a full school year.

The rationale behind this policy, says Dean Suarez, is to ensure that students returning from medical leave are fully ready to come back. Two semesters gives students enough time to be sure they’ve recovered and that they’ve experienced a “sustained period of recovery,” she says.

Likewise, Johnson says students are much more likely to experience a successful return to Brown after two semesters away, rather than one. “We don’t want our students to come back and take another leave,” she says.

Students eligible for medical leave are well aware of the reasoning behind this policy, but it doesn’t help to allay their fears.

“I have a definite and very large problem with the two-semester leave policy,” Lauren says. “A year is an excessively long time, I think—certainly not everyone’s problems can be solved in a semester, but who’s to say it can take two or more?”

As Lauren and other students who have gone on medical leave can attest, it’s not just the idea of going home that frightens them—it’s going home for a full year, with nothing to do and almost no one to see.

“It doesn’t feel great when none of your friends are there, and you don’t have anything at the moment planned,” Johnson says. “For some students, that seems very scary.”

According to Johnson, the vast majority of medical leave cases involve depression, but conditions such as eating disorders also qualify students for time away from Brown. With this in mind, a few important questions begin to crop up.

Does it really make sense to send depressed and troubled students home, when their friends and those they’re close to are away at college? What if these students have problems with their parents? Is it reasonable to condemn them to another year in their company? Can we really be sure that the best solution for every troubled student is an unproductive year at home? And isn’t there something to be said for sorting out these issues here at Brown? The answers to these questions aren’t simple—and they vary widely on a student-to-student basis.

Johnson says medical leave is only necessary when a student’s medical condition becomes so severe that he or she is unable to “effectively focus on their studies.”

But reflecting, for instance, on the high incidence of suicide in the past few months at Cornell University, one can’t help but wonder: to what extent is the University’s decision to ship off students influenced by liability issues?

According to Dean Suarez, the answer is none. “Our concern is the students’ wellbeing and welfare,” she says. And there’s no evidence to the contrary.

Students returning from medical leave, meanwhile, often come back to Brown having reconciled with the University’s decision to send them away. More often than not, they realize that they made the right decision—and that they’ve really benefited from their time off.

“My experience has been that, overwhelmingly, the students who have taken a medical leave find it was very helpful and just what they needed,” Suarez says.

One student who was forced to take leave from Brown because of an eating disorder says that when she was sent home, she wasn’t able to appreciate how big a favor the University was doing her.

“I was pissed at the time—I was furious,” she recalls. “It feels like you’re being singled out, and your world is falling apart.”

But after spending some time at home and dealing with a month-long bout of depression, she began to feel better, more like her old self. And she began to realize how much she needed time away from Brown to heal.

“Within a few weeks, I realized how important it was for me to be placed on medical leave,” she says. “For me, medical leave was the right thing, even though I wasn’t able to admit it at the time.”

Lauren, who just returned home a few months ago, is still coping with her depression and anxiety. She doesn’t do much besides go to therapy, drink a lot of coffee and watch a lot of movies. “I ended up befriending all the workers at Starbucks,” she says. “They all know me.”

Johnson says that such behavior is normal for students who go on medical leave—and that, in time, the majority of them find ways to make the most of their time away from Brown. Eventually, once they start to feel like their old selves again, they end up doing something that’s interesting to them—like getting an internship or a job, or finding some volunteer work.

For the time being, Lauren doesn’t have much to look forward to at home, besides more days spent watching movies and at Starbucks, and, as of this week, a new job. But if other students who have taken medical leave before her can serve as an example, it’s likely that she’ll return to College Hill in one year, a much happier person, and a more capable student.